Individual
JOHN EDWARD VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 WALNUT AVE S, LEESBURG, GA 31763-4367
(229) 759-6508
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
(229) 436-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053383
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52063711
BCBS
GA
01
—
7154474
AETNA
GA
01
—
P00051313
RR MCARE
GA
Enumeration date
08/31/2006
Last updated
07/08/2007
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